Research is increasingly clear that prostate cancer risk is not linked to high testosterone but that the hormone oestrogen and certain chemical oestrogens, saturated fat consumption, choline, low melatonin, low vitamin D and infection are known contributors to risk. (This article is revised from earlier articles by Chris Woollams, former Oxford University Biochemist)
Charities such as Cancer Research still say, "We do not know what causes prostate cancer".
This may have come as alarming news to the increasing numbers of men over 50 in the Western world who were being treated for the disease with testosterone-lowering drugs (it used to be high doses of oestrogen and even castration). If you don’t actually know what causes it, how can you treat it with any degree of accuracy?
Prostate cancer may even be set to become the Western world’s number 1 cancer. Although various agencies will state that the lifetime risk is just one in thirteen or 7 - 8 per cent, these figures are not borne out in reality once a man hits the ripe old age of 50. For him, his chances of being diagnosed are more like 33 per cent in Europe and in the USA, it approaches 40 per cent. By the age of 70, it is 70%.
Testing and prostate cancer
When we asked the Helpline at the Prostate Cancer Charity in Hammersmith for the reasons for the growing prostate epidemic they answered that this was due to better diagnosis.
The fact is that this is just not the case. Men over 50 are subjected to ’Digital Rectal Examinations’. This state of the art testing procedure merely tells you the offending gland is swollen. Then follows a PSA test. At best this is 70 per cent accurate - in America it is considered almost useless. PSMA is a far more accurate test, especially if the cancer has spread
Exercise or dairy consumed in the previous 24 hours can give false and high readings setting off the PSA alarm bells. Professor Julian Peto of Oxford University (and Cancer Research UK) at a recent conference to cancer carers said 90 per cent of doctors under 35 surveyed on the PSA test won’t bother to have one when they get to 50 because it is so inaccurate. As an alternative, you might ask about PSMA testing, DHT (Dihydrotestosterone) tests and keep your fingers crossed that the new urine test from East Anglia Medical School arrives on the mass market in the next 25 years! Gleason tests can cause infection with a stay in hospital and antibiotics the answer.In the UK, Mark Emberton has been arguing that the non-invasive Multiparametric MRI is the way forward.
With a PSA of 4 or above and a Gleason of 3+4 or 4+3, some Oncologists have been known to immediately suggest surgery, or radiotherapy. Others suggest 'Watch and Wait'. In Los Angeles, one infamous research study looked at men over 50 years of age who were killed in car crashes. Over half were driving around with prostate cancer totally oblivious to the disease!
The causes of prostate cancer - the drivers of prostate cancer
If you are going to 'watch and wait', would it help you to know exactly what the 'drivers' of prostate cancer are? What could slow its growth, and what might speed it up? But do oncologists really know what helps and what hinders?
On one occasion when I gave a speech on prostate cancer, a doctor from Salisbury approached me. "I’ve been a doctor for over 30 years and for the last ten or so when patients had prostate cancer, I’ve been telling them it is linked to high testosterone levels. Now I’ve got it myself, I’ve searched everywhere, but I can find absolutely no evidence that testosterone either causes or spreads prostate cancer. Yet that's the cancer is treated - cut the testosterone! What is the truth?"
It takes 6-10 years to build a body conducive to cancer, and it is rarely just one thing - more like 5 or six reasons. Indeed with prostate cancer, some experts think it originates in our teens with our lifestyle and diet then.
Prostate cancer and inflammation -
Were you to read articles on PubMed, you would see that prostate cancer is often referred to as 'highly inflammatory' prostate cancer. You do not see that description with CRC, breast cancer, ovarian or lung cancer. Why the 'highly inflammatory' description? Because the cancer is nearly always preceded by a few years of a benign swollen prostate, which most usually comes with urine flow problems.
Why would you have a swollen prostate? Inflammation. And why would you have that? Two reasons stand out - 'infection' and 'oestrogen'.
It is now accepted that inflammation is associated with the initiation of various cancers, and to their development, and that this can be due in part to bacterial infection-induced microenvironmental changes in the cell.
i) Infection -
It is now accepted that inflammation is associated with the initiation of various cancers, and to their development, and that this can be due in part to bacterial infection-induced microenvironmental changes in the cell. By infection we mean pathogens such as bacteria like E coli, or viruses such as the Herpes family, and yeast infections and even parasites. The Herpes Simplex virus, HSV-2, has been linked in a meta-analysis (1) to a higher risk of prostate cancer, and higher levels of HPV are found in men with prostate cancer. A meta-analysis (2) showed HPV-16 was a risk factor for prostate cancer, but HPV-18 was not. EBV has been found in prostate cancer, with higher levels in advanced prostate cancer (3).
The Human Microbiome Project told us that, in any cancer patient, the volume of good bacteria in the gut have declined, individual strains had been lost, resulting in the 'bad' being freer to express themselves. Loss of the good, a gain of the bad - we have research that pathogens are linked to inflammation and are linked to prostate cancer. The University of East Anglia researchers found five families of anaerobic bacteria present in the urine of men with advanced prostate cancer; and researchers from Johns Hopkins linked the family Enterobacteriaceae, which includes E. coli, to prostate cancer. E. coli causes inflammation in the urinary tract and is a known cause of bacterial prostatitis. Prostate cancer and inflammation of the prostate have also been linked to a number of different bacterial infections (4) E col was at a higher rate in the seminal fluid.
Diet plays a critical role in the inflammatory process (5). Make poor food choices and you will feed the bacteria that make inflammatory compounds. Make good food choices and you will make more bacteria that produce anti-inflammatory compounds. Diet can also control viruses, yeasts and parasites.
Smoking is linked to higher rates of prostate cancer - In a study of 2400 prostate cancer patients, those who continued to smoke fared worse with lowered survival. A meta-analysis (6) showed hat smoking increased risk, increased aggression, and increased fatal prostate cancer. The heaviest smokers had 24-30% greater risk of dying from prostate cancer. Even past smokers had a higher risk. But then smoking is proven to lower the volume and diversity of the good in the gut microbiome, allowing the bad to come out to play. Drugs, antibiotics, poor diet, food poisoning, alcohol and stress would also lower the good, allowing the bad to dominate.
It would appear to be a good idea at the first signs of inflammation to Heal Your Gut. Find out how to do this properly (7).
ii) Oestrogen and lowered testosterone -
The Singapore National Cancer Centre showed that anti-oestrogen drugs can reduce the size of an enlarged prostate. Australian research from Concord Cancer Centre in Sydney also concluded that anti-oestrogen drugs could reduce the size of benign, swollen prostates.
The Monash Cancer Institute in Australia later concluded that localised oestrogen can drive prostate cancer, although men need to have to have both oestrogen and testosterone present.
So clearly human oestrogen is an influence on the prostate and there is 'correlative evidence in humans that indicates an effect of estrogen on the prostate gland that is conducive to cancer onset' (8). There is research focusing on the role of the estradiol/estradiol receptor (ER) axis, which is known to control prostate cancer growth and progression (9). There is some evidence that men who take aromatase inhibitors (drugs like Letrozole) or natural compounds (such as the herbal mix, myomin), cut their oestrogen and increase testosterone levels.
Lowered melatonin levels are the typical result of poor sleeping habits, (such as night shift work - male nurses, prison staff - long-haul air travel (stewards, pilots), or EMF disturbance.
Lowered melatonin levels are linked to higher levels of oestrogen-driven cancer in both men and women. Melatonin is principally known as a regulator of human oestrogen - it interferes with and blocks the oestrogen receptor (10). More prostate cancer and more breast cancer is the result. Yes, you can supplement before bed.
However, we now know that the bulk of your melatonin is produced by day. The action of the InfraRed end of sunlight (even on the darkest day) on your mitochondria (your power stations) produces large levels of melatonin, from serotonin, which is produced by your gut bacteria from tryptophan (chicken, turkey, tofu, nuts and seeds). But then, night shift workers may well sleep all day.
Melatonin is also known to have direct action against prostate cancer (11).
Concord researchers went a step further. They concluded that increased oestrogen levels increased prostate cancer risk; and like a number of other studies produced research to show that oestrogen mimics or xenoestrogens (chemicals that surround us everyday and once they enter our bodies also mimic the action of oestrogen) are responsible for decreased sperm counts and increased prostate cancer risk. Such endocrine disrupting chemicals include herbicides like DDT and Lindane, polychlorinated biphenyls, cadmium and even Agent Orange.
Research from the Moscow Cancer Centre showed that oestrogen mimics also deplete folic acid levels, and folate is inversely proportional to prostate cancer risk (12), while the Athlone Technology Institute in Ireland has shown xenoestrogens weaken our immune systems.
In 2006 came the explanation from Dr Thompson from the University of Texas Cancer Centre in Houston. As we age we produce less testosterone and low testosterone is linked to more prostate cancer. In fact, body builders who take testosterone pills and pump iron have less prostate cancer.
According to Thompson, as we go past the age of 50, we become less 'lean and mean'. Fat stores increase; and we make an aggressive oestrogen from them. Our testosterone falls anyway, and oestrogen can reduce it further. But testosterone regulates an enzyme called 5-alpha reductase - lowered testosterone, more enzyme - and this converts testosterone into something much more aggressive - DiHydroTestosterone or DHT. You can find more on the role of 5-alpha reductase and what you can do about it, here. You really should read that article!
Other causes and drivers of Prostate cancer
iii) Being overweight or obese is linked to prostate cancer risk - Having high blood fat levels, being overweight or obese, are strong drivers of prostate cancer. Not least because having higher levels of fat in your body will cause more oestrogen to be made; and fat also stores hold more toxins.
iv) People with high blood fat levels also have more metastases and lowered survival. We know that a molecular switch causes high fats to increase metastases (13). Studies with mice showed that the loss of a protein from the PML gene (most usually turned off in metastatic prostate disease) caused cancer cells to churn out fat molecules so that they could spread. When the mice were given a restricted fat diet, the metastases stopped. During cancer progression, there are changes in lipid metabolism in both prostate cancer cells and immune cells (14). High LDL and triglyceride levels are bad news.
If your fat is over 4.5 mmol/l there's a good argument for taking Atorvastatin, which will also reduce angiogenesis. But take at least 100 mg of ubiquinol CoQ10, and a small aspirin, as atorvastatin can deplete CoQ10 levels, which results in myopathy and even a more aggressive cancer.
By the way, lycopene (from tomatoes and especially cooked tomatoes) blocks 5-alpha reductase, kills E coli and restricts aggressive and fatal prostate cancer. It can also reduce LDL levels.
v) High Saturated fat consumption- We have reported before that Swedish research shows a direct line correlation between dairy consumption and prostate cancer risk. The Singapore National Cancer Centre (March 2003) showed that IGF-1 within milk is linked to prostate cell proliferation (but not necessarily malignancy - although the NCI in the USA says it is linked). Whole milk intake has been linked (15) with prostate cancer risk. Dietary saturated fat, Alpha-linolenic acid and Eicosapentaenoic acid have each been linked (16) to aggressive and advanced states of prostate cancer.
There is even research on a link between saturated fat consumption during your formative years and prostate cancer later in life! Men with high blood fat levels could well be in trouble.
Obesity is also linked to poor blood sugar control, heightened insulin, IGF-1 and leptin levels, insulin resistance and higher triglyceride levels. Yet more risk factors for prostate cancer.
By the way, we do know that when it comes to cancer, there are good fats and bad fats. Switch your saturated fat consumption - beef, dairy, seed oils, coconut oil into unsaturated fat - extra virgin olive oil, oily fats and fish oils and you will lower your metastases and increase survival times.
vi) Low Vitamin D -
Research (17) has shown that your vitamin D levels are highly predictive of biopsy outcomes. Men with blood vitamin D levels below 12 ng/ml had Gleason scores greater than 4+4. Michael Holik at Boston Medical School, is one of the experts in vitamin D, suggests ideal levels should be greater than 50 ng/ml (125 nmol/L) for good health.. Supplementation of vitamin D (5,000IUs per day, if you cannot have 2-3 hours in the sunshine) has been shown to restrict the spread of prostate cancer (18).
In a meta-analysis (19), higher 25-hydroxyvitamin D level were associated with a reduction of mortality in prostate cancer patients and researchers concluded that 'vitamin D is an important protective factor in the progression and prognosis of prostate cancer'.
Vitamin D is a hormone; and the white immune cells such as T-cells, B-cells, dendritic cells and others.have receptor sites for vitamin D. It activates your immune system. So, the bad news is that low blood levels of vitamin D could have resulted in no 'arming' of your immune system. It simply couldn't cope with the emerging cancer. However the good news is that if you get your blood levels to 125-150 nmol/L, you will have a fully armed immune system, ready willing and able to do battle with your cancer.
vii) Lack of exercise
Lack of exercise is also a risk factor for prostate cancer. Low exercise levels decrease your blood oxygen and is associated with greater fat stores.
Exercise strengthens your body increasing testosterone in men and causing a reduction in 5-alpha reductase. It produces endorphins, hormones that cut stress; it cuts fat stores and the production of oestradiol, it could well help you sleep better at night, you are likely to produce more melatonin, and it will help oxygenate your body. You should aim to be 99% when using an oximeter.
Did I mention stress just then? There's research showing stress can be linked to a greater level of progression in prostate cancer (20). It does it by actually altering cancer-related genes in the prostate.
In fact, there is a crucial 'Bermuda Triangle' you need to observe if you want to beat prostate cancer. In the three corners are - a healthy diet, vigorous exercise and ... fat control.
Prostate cancer - Cutting the causes and drivers
* Take exercise - aerobic and weights. Don't have fat stores
* Take vitamin D, and go in the sun.
* Heal your Gut - kill the pathogens
* Consume a high soluble fibre, good fat diet. The Rainbow Diet.-
* Avoid saturated fat and choline - dairy, eggs, mass market beef, bacon, salami, krill oil and chicken fat (all contain choline, which forms phosphatidyl choline, a driver of prostate cancer. Almost all prostate cancers are 'choline-avid' Check your multivitamin and B complex too! Avoid the other high saturated fat compounds like coconut oil.
* Avoid oestradiol drivers like grapefruit, its juice and large Seville type oranges. And Herbicides and pesticides; and clean up your toiletries bag.
* Make green vegetable juices with high levels of broccoli and kale (and Lemon Peel). . You can even add some zeolite to detox the poisons from your body.
* Take Melatonin, Lycopene, Ubiquinol and even Myomin.
You could talk to Chris Woollams about having a Personal Prescription.
You could watch his interview with Prostate cancer Professor Robert Thomas of Addenbrooke's on YouTube;
or, his video with his patient Mark Gittens who completely beat prostate cancer;
or, see Chris being interviewed on YouTube by CANCERactive Chairman Larry Brooks on the questions people ask on Prostate cancer.
Go to: Prostate Cancer Overview - symptoms, causes and treatment alternatives
Go to: Prostate cancer - Latest News, Latest Research
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References
1. Herpes simplex virus type 2 or human herpesvirus 8 infection and prostate cancer risk: A meta-analysis - Biomed Rep. 2013 May; 1(3): 433–439.
2. Human papillomavirus and risk of prostate cancer: a systematic review and meta-analysis; Giorgio I Russo et al; The Aging Male
Volume 23, 2020 - Issue 2
3. Can the Epstein–Barr Virus Play a Role in the Development of Prostate Cancer? Cancers (Basel). 2024 Jan; 16(2): 328.
4. Urinary microbiota in patients with prostate cancer and benign prostatic hyperplasia; Haining Yu et al; Arch Med Sci. 2015 Apr 25; 11(2): 385–394.
5.. Gut microbiome study links Rainbow Diet foods to good health - https://the-rainbow-diet.com/articles/the-colourful-mediterranean-diet/study-links-rainbow-diet-foods-to-good-health/
6. Smoking as a Risk Factor for Prostate Cancer: A Meta-Analysis of 24 Prospective Cohort Studies; Michael Huncharek et al; Am J Public Health. 2010 April; 100(4): 693–701.
7. Heal your gut article by Chris Woollams - https://chriswoollamshealthwatch.com/featured/heal-your-gut-now-hug-it/
8. Estrogen action and prostate cancer; Jason L Nelles et al; Expert Rev Endocrinol Metab. 2011 May; 6(3): 437–451.
9. Estrogens and Their Receptors in Prostate Cancer: Therapeutic Implications; Erika Di Zazzo et al; Front Oncol. 2018; 8: 2.
10. Melatonin-induced oncostasis, mechanisms and clinical relevance. Cardinali D. P., et. al. Journal of Integrative Oncology. 2016,
11. Melatonin impedes prostate cancer metastasis by suppressing MMP-13 expression; Shih-Wei Wang et al; ell Physiol
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12. Folic Acid and Risk of Prostate Cancer: Results From a Randomized Clinical Trial; Jane C. Figueiredo et al; J Natl Cancer Inst. 2009 Mar 18; 101(6): 432–435.
13. Molecular Switch Links High-Fat Diet to Prostate Cancer Metastasis - NCI, Feb 22 2018.
14. Role of Lipids and Lipid Metabolism in Prostate Cancer Progression and the Tumor’s Immune Environment; Aino Siltari et al; Cancers (Basel). 2022 Sep; 14(17): 4293.
15. Whole Milk Intake Is Associated with Prostate Cancer-Specific Mortality among U.S. Male Physicians; Yan Song et al; J Nutr. 2013 Feb; 143(2): 189–196.
16. Dietary Fat, Fatty Acids and Risk of Prostate Cancer in the NIH-AARP Diet and Health Study; Colleen Pelser et al; Cancer Epidemiol Biomarkers Prev. 2013 Apr; 22(4): 697–707.
17. Vitamin D Deficiency Predicts Prostate Biopsy Outcomes; Adam B. Murphey et al; HUMAN CANCER BIOLOGY| APRIL 30 2014.
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20. Stress alters the expression of cancer-related genes in the prostate; Ivan E. Flores et al; BMC Cancer volume 17, Article number: 621 (2017)